Why Nursing Leadership is Essential for Integrated Care

Why Nursing Leadership is essential for Integrated Care A quickly evolving idea within health care reform is integrated care where a person would have both their medical and behavioral health needs addressed within the primary care structure. Given the prevalence of mental health issues in the general population and common medical co-morbities in the seriously mentally ill population, the federal government, consumers and mental health advocates have rallied significant support for integrated care. While models for system integration and templates for care coordination are rapidly emerging, plans for the work force needed to enact integrated care have not moved forward with the same clarity and vision. Integrated primary care will demand a work force with improved mental health assessment skills and require clinicians capable of matching the intensity of services with the intensity of need around both medical and behavioral issues. Integrated care will also require clinicians with strong interpersonal skills who are capable of resonating with a person’s self state and apprehending his/her narrative of illness. Only with this interpersonal connection will the clinician create the compassionate environment that allows conditions of hope to flourish. This presentation discusses the growing interest in situating integrated care in a person-centered health care home, the implications of adopting this framework, and the unique capabilities nurses bring to this model, particularly interpersonal skills and the compassion necessary to stimulate therapeutic optimism. A popular strategy in creating integrated health care services is to bring in a mental health professional to supplement the primary care practitioner’s skills. But by virtue of their training, NPs have the base for both sets of skills, particularly for the relationship building that is critical to mental health care. It is these interpersonal skills that will create the requisite culture for patient-centered care; yet skills that without nursing leadership will be easily overlooked by health care planners. Strategies for increasing nursing presence in national work force planning are discussed. Discussion will center on what material needs to be added to nurse practitioner training to facilitate interested NPs success in leading culture changes toward patient-centered care and effective integrated care.